How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Facility | None | $14.13 | $14.13 | $14.13 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $21.88 | Professional | None | $14.13 | $14.13 | $21.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $12.88 Median $16.22 Typical High $67.61 | Facility | None | $12.88 | $16.22 | $67.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $37.15 | Professional | None | $12.88 | $12.88 | $37.15 |
Blue Shield Setting Professional Modifier None Typical Low $26.30 Median $40.74 Typical High $85.11 | Professional | None | $26.30 | $40.74 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Contra Costa Health Setting Professional Modifier None Typical Low $37.15 Median $40.74 Typical High $50.12 | Professional | None | $37.15 | $40.74 | $50.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $23.99 Median $37.15 Typical High $102.33 | Professional | None | $23.99 | $37.15 | $102.33 |
Lucent Health Setting Professional Modifier None Typical Low $275.42 Median $316.23 Typical High $316.23 | Professional | None | $275.42 | $316.23 | $316.23 |
Optum Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
Providence Setting Facility Modifier None Typical Low $14.13 Median $37.15 Typical High $72.44 | Facility | None | $14.13 | $37.15 | $72.44 |
Providence Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Sutter Health Plus Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
United Setting Professional Modifier None Typical Low $14.45 Median $15.49 Typical High $45.71 | Professional | None | $14.45 | $15.49 | $45.71 |
7 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.08 Median $7.08 Typical High $10.96 | Professional | 52 · Reduced service | $7.08 | $7.08 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $2.82 Typical High $4.37 | Professional | 53 · Discontinued | $2.82 | $2.82 | $4.37 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.72 Median $10.72 Typical High $16.60 | Professional | 54 · Surgery only | $10.72 | $10.72 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $2.14 Typical High $3.31 | Professional | 55 · Aftercare only | $2.14 | $2.14 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.45 Typical High $2.19 | Professional | 56 · Pre-op care only | $1.45 | $1.45 | $2.19 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.75 Median $3.63 Typical High $16.60 | Professional | RR · Rental | $2.75 | $3.63 | $16.60 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $20.89 Median $27.54 Typical High $125.89 | Professional | UE · Used equipment | $20.89 | $27.54 | $125.89 |
Where California sits
The same service costs 2.8 times more in Hawaii than in New York. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
California· 47th of 51
$15.14
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.